Ovarian Reserve and AMH Testing

What Is Ovarian Reserve?

Ovarian reserve refers to the number of eggs a woman has remaining. Every woman is born with all the eggs she will ever have, and that supply declines over time, independent of pregnancy, ovulation, or hormonal birth control use. Ovarian reserve testing gives your care team an estimate of that remaining supply, which is one piece of a broader fertility picture alongside your age, health history, and other findings.

How Ovarian Reserve Is Tested

A few tools are commonly used together to estimate ovarian reserve:

• AMH (anti-Mullerian hormone). A simple blood test measuring a hormone produced by small follicles in the ovaries. AMH is one of the more commonly used markers because it can be tested on any day of the cycle.
• Antral follicle count (AFC). An ultrasound count of the small follicles visible in the ovaries at the start of a cycle.
• FSH and estradiol (day 2-3 of your cycle). Bloodwork that shows how the pituitary gland is responding to ovarian reserve; typically drawn early in the cycle.

Your provider may order one or more of these, particularly when planning ahead of IVF.

What AMH Testing Can and Cannot Tell You

AMH is a helpful marker of egg quantity. It does not measure egg quality, and it is not a guarantee of whether or when you will conceive. A lower AMH result narrows certain paths and timelines worth discussing, but it does not close every option. Many patients with lower AMH levels go on to build the families they are working toward, often with an adjusted plan developed together with their care team.

Why Your Provider May Recommend Ovarian Reserve Testing

Ovarian reserve testing is commonly used to:

• Estimate egg supply as part of a broader fertility evaluation
• Help plan IVF protocols, including estimating how the ovaries may respond to stimulation medication
• Support family planning conversations, including decisions around egg freezing timing
• Contribute to the evaluation of certain conditions, such as PCOS, where AMH levels are sometimes elevated

What to Expect

The AMH blood draw requires no special preparation and, unlike some other fertility hormone tests, can be done on any day of your menstrual cycle since AMH levels remain relatively stable throughout the month. Antral follicle count is measured with a transvaginal ultrasound, typically performed early in your cycle.

Results are reviewed alongside your age and fertility goals to build a complete picture rather than relying on one number alone.

What Your Results Might Mean

Your care team will walk you through what your specific results suggest in the context of your age and goals. In general terms:

• Higher-than-expected AMH, particularly alongside irregular cycles or other symptoms, may prompt a conversation about PCOS. Learn more about types of PCOS.
• Levels considered typical for your age generally suggest a fertility timeline consistent with expectations for someone your age.
• Lower levels may suggest a reduced ovarian reserve, which can be a reason to move forward sooner with family planning conversations, egg freezing, or fertility treatment, depending on your goals.

No single result determines your path forward. It is one data point your specialist will discuss with you directly.

About This Page

Meet George D. Kofinas, MD, FACOG

As the compassionate leader of Kofinas Fertility Group and a distinguished authority on fertility medicine, Dr. Kofinas has used his depth of knowledge and sharp intuition to help thousands of couples start families of their own. Dr. Kofinas has written and spoken about the full...

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By: George D. Kofinas, MD, FACOG
Reviewed By: George D. Kofinas, MD, FACOG

Published: Nov 10th, 2026

Last Reviewed: Nov 10th, 2026